Study of community-acquired bacteraemias managed in a medical department
Abstract number: R2520
Loupa C., Kouppari G., Petrou G., Romanos K., Antonopoulou H., Zoumberi M., Tsimoranga M., Lelekis M.
Objectives: To analyse clinically and microbiologically the cases of community-acquired bacteraemias which were managed in a medical department of a 300 bed Hellenic hospital.
Methods: We studied prospectively all consecutive cases of community-acquired bacteraemias diagnosed (Bactec, Becton Dickinson) and managed in our 28-bed medical department.
Results: During a 32-month period, community-acquired bacteraemia was diagnosed in 90 patients (34 men, mean age 74.9 years), out of which 77 were evaluable for analysis. There were 89 different bacteria isolated, of which 68 were considered clinically significant. The pathogens were Gram(-) (51/68), Gram(+) (16/68) and fungi (1/68). Among Gram(-), E. coli (31/51) and Klebsiella spp. (8/51) were the most common pathogens, while S. aureus (7/24) and Streptococcus spp. (7/24) were the most common among Gram(+). There was also one case of C. albicans in an old patient with severe underlying diseases and immunosuppression. The most common diagnoses were UTI (35/77), biliary tract infection (15/77) and endocarditis (8/77). 71/77 patients received empiric antibiotic treatment and 6 according to blood culture results. The most common empiric treatment was monotherapy with ampicillin/amoxicillin+inhibitor (33/71), while combination treatment was given in 14/71 patients. According to pathogen sensitivity, empiric treatment proved appropriate in 56/71 cases. Modification of the initial treatment was done in 41/77 cases for various reasons. Mean duration of treatment was 12 days and the outcome was successful in 65/77 cases.
Conclusions: UTIs were the most common cause of bacteraemia in our patients. Gram-negatives and especially E. coli were the predominant pathogens. In most of the cases patients received empiric treatment, appropriate in the majority of cases, and the outcome was successful in 84% of cases.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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